The Effect of Mask Use on the Ocular Surface During the COVID-19 Pandemic

Objectives:The new coronavirus disease 2019 (COVID-19) pandemic emerged in Wuhan, China in October 2019 and spread rapidly all over the world, making extended mask use an inescapable rule of daily life. Literature data indicate that the use of face masks increases the symptoms of dry eye in addition to preventing the spread of COVID-19. The aim of our study was to evaluate the relationship between the clinical signs and symptoms of dry eye and the duration of mask use in healthy individuals using regular face masks.Materials and Methods:Thirty-five patients aged 20-60 years with no additional ophthalmologic pathology were included in the study. Participants were stratified by duration of face mask use: ≤6 hours/day (group 1) and >6 hours/day (group 2). The patients were assessed with the ocular surface disease index (OSDI) questionnaire, fluorescein ocular surface staining, and tear break-up time (TBUT) to evaluate the effect of extended mask use on the ocular surface.Results:A total of 62 eyes of 35 patients, 20 women (57.1%) and 15 men (42.9%), were included in the study. The two mask use duration groups had similar OSDI values (p=0.618). When the ocular surface staining pattern was examined according to the Oxford scale, 50% (10/20) of the eyes in group 1 were assessed as stage 1 and the other 10 eyes as stage 0. In group 2, 47.6% (20/42) of the eyes were assessed as grade 1, 11.9% (5/42) as grade 2, and 4.7% (2/42) as grade 3.Conclusion:Face mask use was shown to cause decreased TBUT and ocular surface staining even in healthy individuals. Further studies are needed to investigate changes in tear film after extended daily mask use

Yaş Tip Yaşa Bağlı Makula Dejenerasyonunda Kompleman Faktör H Cc ve Tt Polimorfizminin Intravitreal Anti-Vegf Tedavisi

The purpose of this study is to evaluate the effect of the komplement factor H (CFH) Y402H CC and TT polymorphisms on treatment response to intravitreal ranibizumab injection in patients with wet type Age Related Macular Degeneration (ARMD). 193 patients with CNV secondary to ARMD followed up for at least 6 months of follow up, and with at least 3 ranibizumab injections were included in the study. At the last examination increase in visual acuity (VA) of 5 letters or more compared to the initial VA was regarded as good response, and decrase in VA of 5 letters or more compared to the initial visual acuity was evaluated as poor response. Genetic analysis was done by PCR melting curve analysis. In the statistical evaluation, SPSS version 18 software was employed. The mean age of the patients was 71.01 (55-86), the mean follow-up was 13.34 (6-36) months and the mean number of injections was 4.02 (3-15). There were 96 patients in the good response group (Group 1), and 97 patients in the poor response group (Group 2). The initial VA in group 1 was found to be 41.34 (10-64) letters, the initial central macular thickness (CMT) was 213.40 (126-494) µm, and the initial lesion width was 3760 (1430-6430) µm. The initial VA in group 2 was 52.89 (26-82) letters, the initial CMT was 257.60 (115-882) µm, the initial lesion width was 4460 (1000-7650) µm. There was no statistically significant difference between the two groups in terms of the initial VA and CMT (p= 0.094, p= 0.083). However, there was a statistically significant difference between the groups in terms of the width of the initial lesion (p= 0.003). In group 1, 15 CC, 30 TT, 51 TC, in group 2 49 CC, 2 TT, 46 TC allelles were found and the distribution was significantly different between the two groups (p= 0.012). Change in the distribution of genotypes was not associated with either the lesion size or VA (p= 0.841). Fibrosis developed in 12 patients who were all poor responders. It is observed that CFH Y402H CC accompanied poor response and TT accompanied good response in this series of ARMD patients undergoing ranibizumab therapy.Bu çalışmadaki amacımız yaş tip yaşa bağlı makula dejenerasyonu (YBMD) olan hastalarda intravitreal ranibizumab tedavisine yanıtta kompleman faktör H (CFH) Y402H CC ve TT polimorfizminin etkisini araştırmaktır. Yaş tip YBMD nedeniyle en az 3 kez intravitreal ranibizumab enjeksiyonu yapılmış, en az 6 ay izlenmiş 193 olgu yanıta göre iyi ve kötü olmak üzere iki gruba ayrılıp, periferik kanda CFH Y402H CC ve TT polimorfizmi çalışılmıştır. En son muayenede başlangıca göre görme keskinliği (GK) ETDRS eşeli ile 5 harf ve üzeri artanlar iyi yanıt, 5 harf ve daha fazla azalanlar kötü yanıt olarak sınıflandırılmıştır. Genetik analiz için PCR yöntemi ile erime eğrisi analizi uygulanmıştır. İstatistiksel analizde SPSS 18 programı kullanılmıştır. Hastaların ortalama yaşı 71.01 (55-86), ortalama takip süresi 13.34 (6-36) ay, ortalama enjeksiyon sayısı 4.02 (3-15) olarak saptanmıştır. İyi yanıt grubunda (Grup 1) 96 hasta, kötü yanıt grubunda (Grup 2) 97 hasta yer almıştır. Grup 1'de başlangıç GK ortalama 41.34 (10-64) harf, OKT'de santral makula kalınlığı (MMK) 213.40 (126-494) µm, FFA'da lezyon genişliği 3760 (1430-6430) µm olarak saptanmıştır. Grup 2'de başlangıçta GK ortalama 52.89 (26-82) harf, MMK 257.60 (115-882) µm lezyon genişliği 4460 (1000-7650) µm olarak saptanmıştır. İki grup arasında başlangıç GK ve MMK açısından istatistiksel olarak anlamlı fark saptanmamıştır (p= 0.094, p= 0.083). Gruplar arasında başlangıç lezyon genişliği açısından ise anlamlı fark saptanmıştır (p= 0.003). Grup 1'de alel dağılımı 15 CC, 30 TT, 51 TC, grup 2'de ise 49 CC, 2 TT, 46 TC olup iki grup arasında dağılım anlamlı farklı bulunmuştur (p= 0.012). Genotip dağılımı ile lezyon genişliği ilişkili bulunmamıştır (p= 0.841). Tedavi sonucunda kötü yanıt grubunda 12 olguda fibrozis gelişmiştir. Yaş tip YBMD'nin intravitreal ranibizumab tedavisine yanıta etkisinde CFH Y402H CC'nin kötü yanıta, TT'nin ise iyi yanıta eşlik ettiği görülmektedir. Kötü yanıt için bir diğer risk faktörünün de lezyon genişliği olduğu saptanmıştır

A case of Biateral Extensive Persistent Pupillary Membranes with Amblyopia and Cataract

Persistent pupillary membrane represents a congenital remnant of the anterior tunica vasculosa lentis. It can be associated with other ocular pathologies. These membranes can cause deprivation or anisometropic amblyopia. The choice of treatment depends on the patient’s age and the characteristics of the membranes. In this paper, we report the findings in a 21-year-old female patient with bilateral persistent pupillary membranes, amblyopia, and cataract. (Turk J Ophthalmol 2013; 43: 70-2

Evaluation of Keratoconus Disease with Tear Cytokine and Chemokine Levels Before and After Corneal Cross-Linking Treatment

Objectives: To compare tear cytokine and chemokine levels of keratoconus (KC) patients with controls to perceive etiology distinctly and to clarify the molecular changes after cross-linking (CXL). Methods: Tear samples were gathered from 34 participants in this prospective study. Participants underwent anterior and posterior segment examinations with slit-lamp biomicroscopy. Patients were assessed by corneal topography before and 3 months after CXL. Flat (K1), steep (K2), and average keratometry (Kmean), cylinder (CYL), and central corneal thickness (CCT) values were evaluated. After 3 months from CXL, samples were re-collected, and comparisons were made with preoperative values. Results: Levels of IFN-gamma, IL-8, IL-12, IL-17, TNF-α, IL-4 and IL-13 were detected higher in KC patients (p= 0.008, p= 0.047, p= 0.001, p= 0.001, p= 0.001, p= 0.001, p= 0.027, respectively). After CXL IL-4, IL-5, IL-6, IL-7, IL-8, TNF-α levels showed significant decrease (p= 0.005, p= 0.045, p= 0.010, p= 0.022, p= 0.001, p=0.002, respectively). As for the topographic measurements, postoperative CCT values were increased whereas Kmean reduced after CXL (p < 0.001, p = 0.015, respectively). (p= 0.001, p= 0.027, respectively).Conclusion:Our findings imply that inflammation plays a key role in the development of KC and that this link is influenced by CXL therapy

The Value of Fortified Aminoglycoside/Cephalosporin Treatment as First-Line Treatment and in Fluoroquinolone-Resistant Bacterial Keratitis

Objectives: Topical application of fluoroquinolone antibiotics is thought to be as effective as fortified antibiotics. The aim of this study was to evaluate the efficacy of fluoroquinolones as an alternative to fortified antibiotic therapies

Influence of video display terminal use and meibomian gland dysfunction on the ocular surface and tear neuromediators.

Objective: To evaluate the effects of video display terminal (VDT) work and meibomian gland dysfunction (MGD) on ocular surface parameters, tear cytokine and substance P (SP) levels, and their association with dry eye disease (DED). Methods: This cross-sectional study included 60 patients with evaporative DED and 20 healthy individuals. The DED patients were divided into three groups according to daily VDT work time and presence of MGD. The ocular surface and tear film were assessed using the Ocular Surface Disease Index questionnaire (OSDI), tear film break-up time (TBUT), ocular surface staining, Schirmer II test, and corneal sensitivity. MGD was evaluated with meibography. Corneal nerve alterations were evaluated using in vivo confocal microscopy (IVCM). The tear levels of 30 cytokines and SP were examined. Results: Compared to controls, DED patients had higher OSDI score (p < 0.001), increased corneal staining with fluorescein and lissamine green (p = 0.046, p = 0,038), and lower TBUT (p < 0.001). Tear interleukin-6 levels were higher in DED patients, while tear SP levels did not differ between the groups (p = 0.265). VDT work time showed a weak positive correlation with OSDI (r = 0.274, p = 0.014) and SP level (r = 0.284, p = 0.011). Conclusion: The results of this study show that VDT use and MGD have an adverse effect on the ocular surface. It was also observed that the combination of VDT use and MGD did not significantly increase the ocular surface disease, but longer VDT exposure may be associated with more complaints of ocular discomfort

THE ASSOCIATION OF ARCUS SENILIS WITH EXFOLIATION SYNDROME AND CARDIOVASCULAR DISEASE IN ELDERLY POPULATION

Introduction: This study aimed to evaluate the relationship between commonly observed ocular conditions in older aged population, arcus senilis and exfoliation syndrome and to evaluate their association with systemic vascular disease